A diagnosis is a working hypothesis. It serves as a guide to putting together a treatment plan. In some cases, the diagnosis of a mental health condition seems very clear, but sometimes it can be difficult even for an experienced mental health professional to determine the right diagnosis.
Receiving a diagnosis of a mental health condition can be a relief—when you learn that you or someone you care about has a condition that’s treatable—but it can also feel confusing or overwhelming. Consider taking a friend or family member to the doctor’s appointment, and ask your friend or family member to take notes. Ask your healthcare provider these questions:
-- What additional information can I provide to help you assess my condition?
-- What information in particular led you to this diagnosis?
-- Do my symptoms suggest another possible diagnosis, in addition to or instead of the diagnosis I’ve been given?
-- Have you ruled out other diagnoses?
-- What are the expectations for recovery with this diagnosis?
What is a diagnosis?
Some individuals have symptoms that suggest more than one mental health condition. Others have symptoms that evolve and change over time. Still other individuals have symptoms that do not meet formal criteria for a specific mental health diagnosis.
In cases where it isn’t possible to arrive at a clear diagnosis right away, treating the symptoms (for example, anxiety or insomnia) can be a reasonable approach to take until the symptoms either respond to treatment or develop into a more easily identified condition.
Correctly identifying a mental health condition is very important:
- An accurate diagnosis is necessary to determine the right kind of treatment
- Misjudging a diagnosis can lead to selecting the wrong treatment – or to no treatment at all in situations where treatment is needed
- The wrong choice of treatment could have very serious consequences
- The right treatment can make a hugely positive difference in a person’s life
Ask your healthcare provider these questions: What additional information can I provide to help you assess my condition?
Ask your provider if it would be helpful for a friend or family member to provide additional information about you. Ask if it would it be helpful if you tracked your moods or kept a record of feelings, behaviors or events. Find out whether there is any additional medical information that might be relevant to the diagnosis. Ask if the provider would like to know about family members who may have shown similar symptoms, whether or not the family members received an official diagnosis.
What information in particular led you to this diagnosis?
Conclusive diagnostic tests do not yet exist for mental health conditions, so a diagnosis is based largely on the clinician’s training, expertise, and judgment. Ask whether your provider has treated a lot of people with this diagnosis. Find out how typical your situation and set of symptoms are for someone with this diagnosis. Ask which of your signs and symptoms most clearly suggest this diagnosis.
Do my symptoms suggest another possible diagnosis, in addition to or instead of the diagnosis I’ve been given?
Sometimes there’s a clear set of symptoms and a clear diagnosis, while in other cases symptoms may suggest more than one mental health condition. Ask whether any of your symptoms are inconsistent with the diagnosis you’ve been given. Is it possible that you may have another mental health condition in addition to, or instead of, the condition that’s been diagnosed?
Have you ruled out other diagnoses?
If you have significant remaining symptoms even after being treated, ask whether the remaining symptoms could indicate that the original diagnosis was incorrect, or that you might have other, additional, mental health conditions. Is there a particular specialist who should be consulted?
What are the expectations for recovery in individuals with this diagnosis?
While no one can guarantee what your outcome will be, it should be possible for a healthcare provider to tell you his or her general expectations. Is it likely that your symptoms will be eliminated with treatment, or will treatment be used to manage your symptoms? Is this a diagnosis you will always carry?
NOTE: On this page, “you” and “your” are used to refer to either you or someone you care about.
This page is adapted from David Mischoulon, MD, PhD and Edward Messner, MD, “The 8 Habits of Effective Mental Health Consumers,” unpublished manuscript.